New understanding of the role of cerebrospinal fluid: Offsetting of arterial and brain pulsation and self-dissipation of cerebrospinal fluid pulsatile flow energy
Section snippets
Background
Traditionally, CSF is produced mainly by the choroid plexus located in the ventricles, which flow to the subarachnoid space and is absorbed by the venous sinus via the arachnoid granulation [1], [2], and recently CSF secretion and absorption is also known to occur in the brain parenchymal capillary [3]. However, CSF secretion and absorption takes place in a closed and limited cranium, and the intracranial components consisting of the CSF, brain parenchyme, cerebral vessels are also confined to
Hypothesis
We propose a new role of CSF in which CSF participates in the buffer and dissipation of intracranial arterial blood flow energy in the intracranial space by the CSF pulsatile flow. Also, we suggest a method of CSF pulsatile flow energy dissipation that arises in the intracranial space due to each cardiac pulsation from several different perspectives and chronological sequence, and which will show that the combination of CSF flow vectors will offset each other (Fig. 1).
If the CSF pulsatile flow
Testing the hypothesis
In order for the CSF bulk flow to cause intracranial space arterial blood flow energy to pass through the venous outflow and be secreted, the CSF bulk flow volume must be far greater than the CSF pulsatile flow volume. In reality, the CSF pulsatile flow volume is greater by a factor of more than a 100 than the CSF bulk flow volume, it is impossible for the majority of the CSF pulsatile flow to be discharged via the CSF bulk flow through the venous outflow. Therefore, it is obvious that the CSF
Conclusion
The hypothesis by the authors is that arterial and brain pulsation energy offsetting and dissipation mechanisms within the intracranial space may be explained by self dissipation of the pulsatile CSF flow energy. In addition, it is thought that our hypothesis will be able to explain the arterial pulsation offsetting and decrease in chronic obstructive hydrocephalus, and the mechanisms involved during ventricular dilatation in communicating hydrocephalus without mean ICP changes.
Conflict of interest statement
None declared.
References (16)
- et al.
Hypothesis for the lateral ventricular dilatation in communicating hydrocephalus: new understanding of the Monroe–Kellie hypothesis in the aspect of cardiac energy transfer through arterial blood flow
Med Hypotheses
(2009) - et al.
Phase contrast cine magnetic resonance imaging: normal cerebrospinal fluid oscillation and applications to hydrocephalus
Neurosurg Clin N Am
(1993) - et al.
New concept of cerebrospinal fluid dynamics in cerebral venous sinus thrombosis
Med Hypotheses
(2008) - et al.
Pathways of fluid drainage from the brain-morphological aspects and immunological significance in rat and man
Brain Pathol
(1992) The blood–brain barrier
J Physiol
(1976)Radiological assessment of hydrocephalus: new theories and implications for therapy
Neurosurg Rev
(2004)- et al.
Pulsatile brain movement and associated hydrodynamics studied by magnetic resonance phase imaging. The Monroe–Kellie doctrine revisited
Neuroradiology
(1992) Cerebrospinal fluid circulation and associated intracranial dynamics. A radiologic investigation using MR imaging and radionuclide cisternography
Acta Radiol Suppl
(1993)